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August Issue 2016
Inside This Issue
40 Years of Life Flight, 40 Days of Thanks
Memorial Hermann Life Flight Celebrates 40th Anniversary by Extending its Appreciation to the Community It Serves By Collette Rhiannon
MS patients in Houston have access To wellness program See pg. 18
INDEX Mental Health...............pg.3 Oncology Research......pg.7 The Framework..............pg.8 Age Well Live Well........pg.12
Four decades after launching the innovative air ambulance service known today as Memorial Hermann Life Flight®, Memorial Hermann Health System will commemorate the program’s momentous 40th anniversary by expressing its gratitude to the community that has helped make the lifesaving service possible. The campaign, called “40 Years of Life Flight, 40 Days of Thanks,” kicked off with an official proclamation from Houston Mayor Sylvester Turner’s office, presented by Houston City Council Member Jack Christie on the helipad of Life Flight’s home base at Memorial Hermann-Texas Medical Center (TMC), declaring Aug. 1, 2016 as
“Memorial Hermann Life Flight Day.” “Today is a special day, not just for Life Flight, but for the entire city of Houston, as we reflect back on the pioneering leadership that helped make this program possible and celebrate the many accomplishments that have defined Life Flight’s reputation as a trailblazer among air ambulance
services,” said Brian Dean, Senior Vice President and CEO of Memorial Hermann-TMC. Throughout the next 40 days, the Life Flight team will be showing their gratitude in various ways, including extending their thanks to EMS partners and first responders throughout see Life Flight page 19
Rice lab discovers titanium-gold alloy that is four times harder than most steels By Jade Boyd Rice University
Pearland Medical Center hosts fallen officers See pg .20
Titanium is the leading material for artificial knee and hip joints because it’s strong, wear-resistant and nontoxic, but an unexpected discovery by Rice University physicists shows that the gold standard for artificial joints can be improved with the addition of some actual gold.
“It is about 3-4 times harder than most steels,” said Emilia Morosan, the lead scientist on a new study in Science Advances that describes the properties of a 3-to-1 mixture of titanium and gold with a specific atomic structure that imparts hardness. “It’s four times harder than pure titanium, which is what’s currently being used in most dental implants and replacement that Morosan and former graduate student Eteri Svanidze, the study’s lead joints.” co-author, were the first to make a pure Morosan, a physicist who sample of the ultrahard “beta” form of specializes in the design and synthesis the compound. But due to a couple of of compounds with exotic electronic lucky breaks, they and their co-authors and magnetic properties, said the new are the first to document the material’s study is “a first for me in a number of remarkable properties. ways. This compound is not difficult “This began from my core to make, and it’s not a new material.” research,” said Morosan, professor In fact, the atomic structure of the of physics and astronomy, of material — its atoms are tightly packed chemistry and of materials science in a “cubic” crystalline structure that’s and nanoengineering at Rice. “We often associated with hardness — was previously known. It’s not even clear see Rice page 19
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Mental Health
Lack of Sleep Increases a Child’s Risk for Emotional Disorders Later NIH-funded Study Reveals Long-term Emotional Effects of Poor Sleep By Lisa Merkl
disorders in later years.
“In particular, we are interested in understanding how children appraise, express, regulate and later recall emotional experiences, both when sleep is adequate and when it is inadequate,” said Alfano, who is the principal investigator of the study and director of the Sleep and Anxiety Center of Houston (SACH). “We focus on childhood, because similar to Candice Alfano, a clinical problems with anxiety and depression, psychologist and associate psychology sleep habits and patterns develop early professor at the University of in life and can be enduring.” Alfano and co-investigator Cara Houston, says children who experience Palmer, who is a postdoctoral fellow inadequate or disrupted sleep are more likely to develop depression and at SACH, are identifying distinct anxiety disorders later in life. Funded emotional processes that, when by a grant from the NIH’s National disrupted by poor sleep, make children Institute of Mental Health (NIMH), vulnerable to developing anxiety the study seeks to determine the precise and depression. To pinpoint these ways inadequate sleep in childhood cognitive, behavioral and physiological produces elevated risk for emotional patterns of emotional risk, they are When asked how lack of sleep affects emotions, common responses are usually grumpy, foggy and short-tempered. While many jokes are made about how sleep deprivation turns the nicest of people into a Jekyll and Hyde, not getting enough shut-eye can lead to far more serious consequences than irritability, difficulty concentrating and impatience.
temporarily restricting sleep in 50 are adequate in duration, however, pre-adolescent children between the they’re finding these emotional effects are less apparent. ages of 7 to 11. Their findings reveal that inadequate sleep impacts children’s emotional health not only by creating more negative emotions, but also by altering positive emotional experiences. For example, after just two nights of poor sleep, children derive less pleasure from positive things, are less reactive to them and less likely to recall details about these positive experiences later. When their normal nightly sleep habits
“Healthy sleep is critical for children’s psychological well-being,” Alfano said. “Continually experiencing inadequate sleep can eventually lead to depression, anxiety and other types of emotional problems. Parents, therefore, need to think about sleep as an essential component of overall health in the same way they do nutrition, dental hygiene and physical activity. If see Mental Health page 19
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Texas A&M planning to create medical school for physician engineers at Houston Methodist Hospital By Stefanie Asin Texas A&M University is planning to create an innovative engineering medical school at Houston Methodist Hospital to educate a new kind of doctor, pending appropriate approvals, who will invent transformational technology for health care, officials announced today. Fifty physician engineers would begin their studies in Fall 2017 at the new Texas A&M University Engineering Medicine School (EnMed) at Houston Methodist Hospital. EnMed would be an integrated educational and research medical school with a focus on innovation and entrepreneurship and a part of the Texas A&M College of Medicine’s MD program and the College of Engineering. EnMed would initially hire 25 faculty members and utilize 75,000 square feet of instructional and research space in the Texas Medical Center. “The medicine of tomorrow will not be practiced in the way that it is today. Medicine is not just about biology, it requires technology development,” said John Sharp, Chancellor of The Texas A&M University System. “This school would not only train doctors, but allow
them to invent new products and take their inventions to the marketplace. EnMed would expand the health care technology market at the Texas Medical Center. The potential economic impact to the region would be huge.” Responsive to the rapid advances in technology, this new type of medical education would prepare professionals with the clinical skills to diagnose symptoms and treat patients, along with the engineering mindset to solve problems, invent new technologies and rapidly move these innovative ideas to practice in patient care.
translational, with the end goal of bringing new solutions to our patients in a timely fashion,” said Mauro Ferrari, Ph.D., president and CEO of the Houston Methodist Research Institute. “I have every confidence that our joint program will create the engineering-based ideas necessary to cure the most challenging diseases.”
the world, but most importantly, would create new transformational educational opportunities for our students."
“As a physician who has long been interested in engineering, I’m particularly excited that EnMed will train a new kind of medical doctor who will be able to design technology to tackle the most complex problems in medicine,” said Marc Boom, M.D., president and CEO of Houston Methodist. “This new collaboration could quickly impact the future of health care.”
EnMed would blend translational research and commercialization opportunities with an innovative medical education model, said Michael K. Young, President of Texas A&M University.
“This is a paradigm shift. The major health care challenges of the future will not only depend on bioengineering, but also require mechanical, chemical, electrical, and computer engineers,” she said. “There are other programs that link medicine with bioengineering, but this is different. All students in EnMed will be expected to invent something transformational before they graduate. These innovators, or “physicianeers”, will radically change the way that health care is delivered.”
An innovative translational research program in medical technology at Houston Methodist Research Institute would also will be part of EnMed. “Everything we do should be
“The presence of a hands-on innovation center combined with an office of technology commercialization is another example of Texas A&M creating dynamic solutions to the great global challenges we face in health care today,” he said. This interdisciplinary learning environment would lead to research and discoveries that would impact the state, nation and
And this focus, said Texas A&M Engineering Vice Chancellor and Dean of Engineering M. Katherine Banks, is what would make this school unlike any other.
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Houston Medical Times
Legal Health
FIVE TIPS FOR ENHANCING COMPLIANCE WITH THE HIPAA RULES Mark S. Armstrong, J.D. Epstein Becker & Green, P.C.
The United States Department of Health and Human Services, Office for Civil Rights (“OCR”), enforces the Federal standards that govern the Privacy Rule, the Security Rule and the Breach Notification Rule of the Health Insurance Portability and Accountability Act (the “HIPAA Rules”). The OCR’s investigations of covered entities and business associates
have recently discovered widespread vulnerabilities which were identified following reported breaches of various causes, including, but not limited to (a) delivering protected health information (PHI) to a business partner without first obtaining a business associate agreement, (b) stolen unencrypted password protected laptop and (c) stolen unencrypted thumb drive. In each case, the OCR entered into a resolution agreement with the covered entity or business associate which resulted in significant monetary payments and a comprehensive corrective action plan. The OCR, through these recent corrective action plans, has identified several important areas where covered entities and business associates should carefully focus to mitigate risks and reduce vulnerabilities. Below are five tips for enhancing compliance with the HIPAA Rules. 1. Perform a Risk Analysis. ∙
At
least
annually,
conduct an accurate and thorough assessment of the potential risks and vulnerabilities to the confidentiality, integrity, and availability of electronic protected health information (“ePHI”) and document the security measures that are implemented to sufficiently reduce the identified risks and vulnerabilities to a reasonable and appropriate level. ∙
The risk assessment
should include security risks and vulnerabilities of: ∙ all facilities and all data systems and networks, and ∙ all electronic equipment and applications controlled, administered, or owned by the covered entity its workforce members, and affiliated staff that contains, stores, transmits, or receives ePHI. ∙
Develop a complete inventory of all electronic equipment, data systems, and applications that contain or store ePHI.
∙
Address and mitigate, through a risk see Legal Health page 21
August 2016
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Oncology Research
Resistance of cancer cells to T cells based immunotherapy By Jorge Augusto Borin Scutti, PhD Houston Medical Times
In the past of few decades immunotherapy has become an essential part of treating some types of cancer, including melanoma, renal cancer, colon cancer, ovarian cancer, and some subtypes of breast cancer by stimulating the immune system to fight cancer cells. It must be emphasized that the presence of lymphocytic infiltrates within the tumor is extremely related with improved outcome mainly by containing CD4+ (the T helper cells) and CD8+ (the cytotoxic T cells) both are very important to immune response against cancer cells by recognizing tumor-associated antigens.
Understanding of the antitumor immunity role of CD4+ and CD8+ has grown considerably since the late 1990´s. These cells have a potential to kill cancer cells and them are well demonstrated by several clinical effects of adoptive transfer of TIL´s (tumor infiltrating lymphocytes) in metastatic melanoma patients, for example. Furthermore, the administration of checkpoints inhibitors such as monoclonal antibodies as Ipilimumab (blocks CTLA-4) and Nivolumab (blocks PD-1) or its ligand PD-L1 (Pembrolizumab) have been showed a increase in medial overall survival in some types of cancer as melanoma, renal cell carcinoma and non-small cell lung cancer. Based on these encouraging clinical results have fairly put immunotherapy at the vanguard of oncological practice. It is notorious that advances in immunotherapy have resulted in notable clinical response
in some patients; however, one of the vastest challenges in cancer therapeutics is the development of resistance and cancer progression on or after treatment. Asking which would be examples of acquired resistance to immunotherapy from clinical trials and model system, Dr. Nicholas P. Restifo from Center for Cancer Research, National Cancer Institute and Center for Regenerative Medicine National Institutes of Health. According to him, there are two mechanism of tumor resistance: Selection of resistant clones, a special form of Darwinian natural selection that comes from the selection of genetic or epigenetic heritable traits that pre exist in the
tumor mass before a therapeutic intervention or acquired resistance at the level of the individual tumor cell also called homeostatic resistance. This second form occurs because tumor cells alter their gene expression in response to interactions with immune cells or their products. Furthermore, according to Dr. Mark J. Smyth, senior scientist and immunology coordinator at QIMR (Queensland Institute of Medical Research) “there are many experimental and clinical examples of naturally acquired or immunotherapyacquired resistance: role in suppressing T cells in the tumor microenvironment as PD1-PDL1, LAG 3, TIM3 and TIGIT”. With the improvements see Oncology Research page 22
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The Framework
Texas Children’s Pavilion for Women announces first-in-Texas Zika clinic
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Texas Children’s Pavilion for Women, one of the nation’s premier facilities for women’s, fetal and newborn health, is excited to announce a first-in-Texas Zika clinic to ensure that as the virus continues to be a global concern, pregnant women at risk of contracting it have access to a team of experts who can provide the latest testing and monitor their pregnancies. Run by the hospital’s maternal-fetal medicine experts, the clinic operates every Friday from 8 a.m. to noon and will see pregnant women who have traveled to Zika-affected countries, have shown symptoms of the Zika virus, or have partners who traveled to Zika-affected countries and/or have
Aagaard, a maternal-fetal medicine specialist and vice chair of research in the department of obstetrics and gynecology at Texas Children’s and Baylor College of Medicine. “In an emerging disease, where new evidence arises daily, having a dedicated group of providers who can keep up with large amounts of crucial information, understand what testing to perform, and discern clinically important information and how to readily apply it is critically important.” In addition to blood, urine, amniotic fluid tests and counseling, the Zika clinic offers a targeted diagnostic ultrasound that can be performed as early as 15 weeks into pregnancy to determine if there are any concerning developmental signs for Zika infection
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in a fetus. Physicians and staff at the clinic are thoroughly prepared to safely Transmitted primarily through and confidently treat any patient who mosquito bites, the Zika virus has exhibits symptoms of the Zika virus. heightened concern among pregnant The Zika clinic at Texas Children’s women as it may increase the risk of Pavilion for Women is the direct microcephaly, a rare neurological birth defect that causes babies to be born outcome of a task force assembled with abnormally small heads and have earlier this year under the guidance of Texas Children’s Obstetrician and Gyabnormal brain development. Emerging necologist-in-Chief Dr. Michael Belfort research is also linking the virus to and Maternal-Fetal Medicine Division other birth defects. As of July 14, 400 Director Dr. Gary Dildy. The task force pregnant women in U.S. states and developed management and research D.C., and 378 in U.S. territories have strategies based on important screening been confirmed to have lab-evidence of criteria outlined by the CDC for a Zika virus infection by the Centers for pregnant women who may have been Disease Control and Prevention (CDC). exposed to the Zika virus. The clinic is Learn more about how to prevent staffed by a registered nurse, medical mosquito bites during pregnancy. assistant and a team of maternal-fetal shown symptoms of the Zika virus.
“It’s crucial we have a Zika clinic at medicine experts including Aagaard, the Pavilion for Women for our patients Dr. Catherine Eppes, Dr. Martha Rac and community,” said Dr. Kjersti and Dr. Magda Sanz-Cortes.
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MD Anderson, NASA and ILC Dover partner on Space Suit Art Project to increase childhood cancer awareness Pediatric cancer patients aim for the moon with space inspired art project
Recently, several of Space City’s best-known institutions — The University of Texas MD Anderson Cancer Center, the National Aeronautics and Space Administration (NASA) and ILC Dover — announced a partnership that brings the benefits of arts and science to pediatric cancer patients while increasing awareness of childhood cancer. More than 530 patients, families, and staff members painted original artwork used to create full-sized suits for the Space Suit Art Project. Born out of an idea from MD Anderson’s Arts in Medicine Program, which helps pediatric patients cope with cancer treatment through art, this project inspired leaders at NASA’s International Space Station (ISS) to support the effort with help from astronauts, scientists and engineers. NASA provided patterns for the suits and worked with ILC Dover, a manufacturing and engineering company that develops NASA space suits, to assemble the suits by stitching the hand-painted art pieces together into a wearable replica space suit. “This project has inspired hope for kids fighting cancer, instilled them with courage and created unity, all while increasing awareness of childhood cancer and the importance of pediatric cancer research,” said Ronald A. DePinho, M.D., president of MD Anderson. “We are so proud of this project and grateful for the passion and support we’ve received from NASA, ISS and ILC Dover. This is a wonderful example of the power of collaboration.”
build community among patients and families.
NOW LEASING PHASE II
“This collaboration highlights both the knowledge and inspiration that flow from the International Space Station,” said Ellen Ochoa, Ph.D., veteran astronaut and director of NASA’s Johnson Space Center. “Our astronauts conduct research on board the orbiting National Laboratory that benefit people around the world, including experiments that may inform future cancer research.”
Leading the effort to connect science, technology, arts and the human spirit are Ian Cion, director of the Arts in Medicine Program; Nicole Stott, retired NASA astronaut and the first person to paint in space; and David Graziosi of ILC Dover. Their collaboration created the Space Suit Art Project, which demonstrates the transformative power of arts in the healing process through three space On average, one in 285 children suits designed to convey different in the US will be diagnosed with meanings: Hope, Courage and Unity. cancer before the age of 20. Similar to The first suit, HOPE was adults, children going through cancer treatment can experience anxiety and stitched together from more than depression. Research shows creative 600 hand-painted art pieces created arts therapy benefits cancer patients by patients, families and staff at MD as mental health and behavioral Anderson. It represents the hope health are positively impacted. At patients and families have as they go MD Anderson, art gives patients through treatment. Their primary hope a sense of control and purpose, is to survive cancer, but it’s deeper than makes them more comfortable in survival. The project inspires hope for the hospital environment, and helps see MD Anderson page 22 medicaltimesnews.com
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Nutrition Corner
PLANT BASED DIET Eat food. Not too much. Mostly plants. –Michael Pollan By Denise Hernandez, MS, RD, LD Houston Medical Times
Lead the Way in Healthcare “The MBA program at the University of St. Thomas gave me the tools to understand all facets of business, from finance to operations to management, which allowed me to move into a senior management position.” Denise Castillo-Rhodes, MBA ’92 Executive Vice President & CFO, Texas Medical Center
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This mantra is a good one to live The latest science in support of by and is one that I, as a dietitian, plant-based diets demonstrates that highly recommend. plant-based diets reduce the risk of What exactly is a plant-based diet, ischemia, hypertension, and type 2 why do I recommend it to clients, and diabetes. These diets also lower LDL how can you implement it into your and blood pressure, reduce body diet? These are the questions that you mass, and reduce overall cancer rate. These lowered risks can be attributed may be asking yourself. to the decreased intake of saturated fat The Dietary Guidelines Advisory and cholesterol and increased intake Committee refers to the plant-based of vegetables (with more fiber and diet as one “that emphasizes vegetables, phytochemicals), nuts, and soy.
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MAKE THE SHIFT 1. Start slow – you can’t make the change overnight. I usually recommend starting off by eating vegetarian one night per week and then slowly increasing it to making an entire day vegetarian. 2. Find a good vegetarian cookbook – take the guesswork out of it and use vegetarian cookbooks as an inspiration to transform your meals. 3. Convert some of your favorite meals to vegetarian meals – If your favorite meal is lasagna, swap the meat portion with vegetables. Or try spiralizing vegetables to replace the noodles in spaghetti.
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Age Well Live Well Foster Grandparents – Improving Lives of All Ages By Jeff Carmack, Managing Editor, Texas Department of Aging and Disability
with the humidity and decided to move to Texas,” she said.
But her illness and forced idleness took their toll. “When you’re used to doing things and then you can’t, you get depressed,” she said. “I had run a restaurant, I had family around—I was “This program really did save my always doing something. Then all of life.” a sudden, everything was taken away. --Deborrah Robinson, Foster When you like to do and to go, it’s hard to be idle. That does something Grandparent to you mentally.”
Study ?
Deborrah Robinson was in a bad spot – “an impasse,” she says. She has a disability and had been seriously ill for a spell. While she was hospitalized, her car was repossessed. And when she got out, by her own admission, all she did was sit and watch TV. “There was a time when I was thinking, ‘What is my purpose?’ “ she said.
Learning about the Foster Grandparent Program and being able to volunteer and give back was a game-changer for her. “We’re helping people and we’re getting helped in return.” The program helps society in two ways, she said. “It’s an opportunity to do something good for the community,
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to give back to these kids. But it’s also good for us seniors who aren’t ready to lay down and die.” Angela Ganner, director of the Head Start Round Rock program, said, “She has that knowledge,” she said. “She’s raised her own kids and her grandkids, and that gives her a perspective and a life knowledge she passes on to her charges.” Today, she’s a walking advertisement for the program. “I tell everyone and encourage them to be a part of it. If you want to still have purpose in your life, if you want to do something really fun and rewarding, and you want to get out of your apartment because you're always complaining about you don't have anything to do—try the program. If you do, I guarantee you you’ll stay.”
A Denver native and motorcycle To learn more about the Foster enthusiast, Robinson moved to Grandparents Program, visit their Texas after attending a biker event in website. Houston 15 years ago. “I fell in love
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St. Joseph Medical Center Launches AngioScreen® Mobile Program Convenient Vascular Portable Screening Empowers Consumers with Heart Health Information Dear Doctors and Staff,
St. Joseph Medical Center (SJMC) has launched an innovative non-invasive mobile screening program to offer consumers important information about their vascular health and risk of heart disease or stroke.
Let us take the guesswork out of fracture referrals. No more waiting for appointments! We at the Orthopedic Care Center wish to offer your patients and staff easy scheduling of patients.
The AngioScreen® mobile program provides information about heart rhythm, neck and leg arteries, blood pressure and fitness. The information is compared to normal levels for the participant’s age group. Immediately following the 15-minute
Our office has extended office hours on Fridays to accommodate patients with fractures. On behalf of the Orthopedic Care Center
Lubor Jarolimek M.D.
Becky Childers, RN and director of the mobile AngioScreen® program said the goal of the program is to empower people with information to discuss with their physician to help lower their risk of a heart attack or stroke. “Participants will see if they have healthy carotid arteries, or if there is some degree of blockage narrowing the flow of blood to the brain and heart,” said Childers. “We also provide
ORTHOPEDIC CARE CENTER 2121 OAKDALE HOUSTON, TX 77004
Call us today! OCC_FractureFridaysFA3_Outlined.indd 1
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AngioScreen Mobile Unit shown here
screening, participants receive an instant color-printed report and digital record, educational materials and a non-diagnostic consultation. The mobile unit is facilitated by a team of experienced healthcare professionals and equipped with the latest imaging technologies.
information regarding blood pressure, pulse rate, heart rhythm, body mass index and ankle brachial index, which tests for risk of peripheral arterial disease.”
“Vascular disease is the leading cause of heart attack and stroke. Most people don’t realize that every 30 seconds an American has a heart attack,” said Sheila Coogan, M.D. vascular surgeon at SJMC. “Participants can take the integrated vascular information provided by our team to a physician so that a preventive action plan can be discussed.”
important to note that AngioScreen® is not a substitute for medical care by a qualified physician and our consultation does not take the place of discussing heart health with a physician; however the screening does provide an excellent base of information that everyone should have about the condition of their vascular system.”
Childers explained that the carotid arteries carry blood to the brain and narrowing of the artery increases risk This program is available of stroke. Thickening of the inner throughout the greater Houston lining of the carotid arteries, which is area and is provided inside a how plaque begins, is correlated with mobile unit available for scheduling blockages of the heart’s arteries. by corporations, health fairs and “Studying the carotid arteries organizations. Additionally, because gives information about the heart’s the equipment is portable, the system circulation and 15 percent of all can be moved to an interior setting, strokes occur because plaque is in a such as a conference room. carotid artery,” added Childers. “It is
August 2016
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PaintFest America brings creativity and healing to cancer patients
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On Monday, July 18, cancer survivors, patients, supporters and family members gathered to share in a therapeutic experience celebrating the power of art in healing. The NCI-designated Dan L Duncan Comprehensive Cancer Center hosted the Foundation for Hospital Art’s PaintFest America campaign, which brings the healing power of art to 50 states, in 50 days, with the Baylor St.
has been providing comfort and love to hospital patients through art for 32 years. The goal of the tour is to create and display artwork with a specific focus on cancer facilities. Each hospital received multiple murals, which feature different designs and offer a paint-by-numbers type approach, creating an inviting and encouraging creative environment for participants of all ages. The campaign as a whole will provide more than 200 murals throughout the United States, including
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Luke’s Medical Center McNair Campus serving as the host location for Texas. The tour, which kicked off in Washington, DC on July 5, will visit 50 cancer-focused institutions across the country, concluding in New York City on August 23. The tour’s stop in Houston hosted dozens of participants, including patients, physicians, friends, family and supporters. Dr. Matthew Ellis, professor and director of the Lester and Sue Smith
unique panels for each state featuring its state bird and flower. Once assembled, the “Stars of Hope” state panels will create a larger 10’ x 15’ mural, which will be assembled on the final day in New York. “As a Cancer Center, we were drawn to participate in this event because it’s easy to see how a project like this can lift the spirits of those undergoing difficult courses of treatment,” said Dr. Kent Osborne, professor and director of
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Breast Center in the Dan L Duncan Cancer Center, was on scene to provide his input into the impact of the event, saying, “PaintFest America is doing something really unique for the cancer community. It’s encouraging to see an organization focus on the healing elements of art and bring it into a supportive setting. We are excited to be involved in the project.” The Foundation for Hospital Art
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Baylor’s NCI-designated Dan L Duncan Comprehensive Cancer Center. “Art can provide creative stimulation and a constructive distraction to the hospital setting.” Following the unveiling at the finale in New York in August, Baylor will receive the special Texas panel to display in our institution, along with the panels that were completed during the event itself.
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At last, MS patients in Houston have access to most effective wellness program Adaptive aquatics classes introduced at the YMCA ease pain and strengthen muscles By Heather Saucier Director of Media Relations YMCA of Greater Houston
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When Cheryl Stitt, 48, was first diagnosed with multiple sclerosis in 2006, not only did she have trouble with balancing, numbness and her vision, the mother of two began losing her identity as a person. “I didn’t know who I was. Who am I?” she recalled thinking. “Can I keeping working? Will I be able to drive? To walk?” As Stitt slowly came to grips with the disease that struck her when she was 38, her doctor urged her to do something rather revolutionary at the time: exercise. While exercise was once discouraged for people with MS – as many can overheat and greatly exacerbate their symptoms – a relatively new theory suggested that exercise in a controlled environment, especially in water, could help alleviate pain and strengthen muscles if done regularly.
time that a formal adaptive aquatics program is available for people with MS in Houston. The YMCA of Greater Houston, in a collaboration with the National Multiple Sclerosis Society in Houston, has launched a pilot program at the Trotter Family YMCA, 1331 Augusta Dr., in which trained and certified aquatics instructors teach classes to MS patients who have had scant access to wellness activities in the past. Anna Holmes, a specialized water aerobics instructor based in Keller, Texas, said by focusing on water walking, range of movement and stretching, conditions such as weak muscles and spasticity can be greatly improved. In the water, where a person’s normal body weight drops to 10 percent, a person can more easily exercise and build core muscles and the muscles surrounding weak points in the body, she said. “I have a student who started out using a walker. He was determined to get stronger and asked me to really
Lisa Sailor, Third from right, and Cheryl Stitt, second from right, enjoy an adaptive aquatics class at Trotter YMCA. Photo courtesy of YMCA Greater Houston.
There was just one problem: Aquatics programs adapted specifically to those with MS were not available in Houston. So, Stitt joined the Langham Creek Family YMCA in Houston and began working out as best she could. It wasn’t long before her balance and gait improved. She met others at the center who also struggled with MS, and before she knew it, Stitt quit her job in sales and became a water aerobics instructor, using her instincts to modify her classes for people with MS and other physical challenges. “I so much enjoy helping people who haven’t exercised before or who have to find out who they are all over again,” she said. “I can relate to them.” This year, Stitt has reason to feel joyous again, as it marks the first August 2016
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push him,” Holmes said. “He just completed the MS 150 peddling with his legs. One hundred and fifty-two miles in two days. Amazing.” The adaptive aquatics classes offered at the Trotter YMCA are open to people with MS, but also to those with other physically debilitating conditions and those who simply desire a gentler workout in the water. Available to participants are elevators, wheelchair ramps, lifts to enter and exit the pool, and in-water platforms that can be used for seating or extra support while standing. “Do you know what it’s like to stand and walk in the water when you can’t on the ground?” said Lisa Sailor, 57, an ambassador for the MS Society in Houston who mostly uses a wheelchair. “It’s emotional. It’s pretty moving, especially if you see YMCA page 22
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Life Flight
Continued from page 1 the region who serve a key role in helping Life Flight retrieve Houston’s critically ill and injured patients, and by visiting campuses across the System for individual meet-and-greets and to thank colleagues for their partnership in saving lives. Memorial Hermann will join the community in celebrating Life Flight’s trailblazing history and excellence in aviation safety and high quality, clinical care with a special social media campaign recognizing the countless lives saved by Life Flight over the years. Using the hashtag #LifeFlight40 on Facebook, Twitter or other social media channels, former patients and community members are invited to share their personal stories with and gratitude for Houston’s saviors in the sky.
community support and fundraising efforts to pay for the service. It costs about $3 million annually to support the program, none of which comes from tax dollars. Along with the celebration, Memorial Hermann-TMC continues to honor the legacy of the founder and long-time medical director of Life Flight, legendary UTHealth trauma surgeon Dr. James H. “Red” Duke, who passed away nearly one year ago on Aug. 25, 2015. Dr. Duke’s visionary leadership helped revolutionize trauma care, not just in Houston, but across the country. In May, Memorial Hermann renamed its trauma institute, one of the nation’s busiest Level I trauma centers, the Memorial Hermann Red Duke Trauma Institute in his memory.
injured or sick, and making sure we were doing our best and maintaining the highest standards of care to ensure the best possible outcomes for patients. As we celebrate another watershed moment in Life Flight’s history, I know Dr. Duke would be immensely proud of what the program has achieved in 40 short years,” said Tom Flanagan, Vice President and Chief Operating Officer of Memorial Hermann-TMC.
Founded on Aug. 1, 1976 as a groundbreaking medical flight program aimed at expediting the transport of critically ill and injured patients across the Greater Houston area, Life Flight was the first air ambulance service in Texas and the second such program in the nation. In the decades since, Life Flight has maintained its premiere “From its earliest days, Life Flight status and evolved to keep pace with has played a critical role in preserving the changing demands of trauma care. Dr. Duke’s vision of providing a robust “The program has evolved from trauma care system for all patients, a service that functions much like regardless of their wealth or status ambulances do today – hastening or whether they lived in the city, the trauma patients as quickly as possible suburbs, the rural outskirts or the to the hospital – to a sophisticated and frontier, as he liked to call it,” said state-of-the-art program that begins Eric Von Wenckstern, administrative delivering advanced, prehospital director of Life Flight. trauma care in the sky,” said Dr.
In addition, the Memorial Hermann Foundation is commemorating the occasion by encouraging the community to continue its philanthropic support of the program by pledging to donate $40 in honor of Life Flight’s 40 years of service. Provided as a community service by Memorial Hermann, Life Flight operates as a hospital-based, “His passion was taking care of Joseph Love, who is only the second non-profit organization and relies on mankind, helping all people who were Medical Director of Life Flight in the
program’s history and an associate professor of surgery at McGovern Medical School at UTHealth. “We are now bringing the lifesaving capabilities of an emergency center directly to the patient. We are witnessing the future of trauma, not just in Houston, but across the country.” Since its inception, the program has expanded from a single helicopter and a handful of crew members to a fleet of six helicopters and 74 crew members capable of retrieving patients within a 150-mile radius of the Texas Medical Center, or worldwide using fixed-wing transport. Each helicopter can carry up to two patients and comes equipped with state-of-the-art emergency medical treatments, including prehospital blood product administration, portable blood warmers, ultrasound diagnostics, video-assisted intubations and tools to open blocked airways. All crew members carry night-vision goggles during flight to help to improve safety. Two years ago, the program became the first air ambulance service in Southeast Texas to be granted authority to fly under instrument flight rules (IFR), which allows the crew to fly when visibility is limited or clouds are low.
Rice
Continued from page 1 published a study not long ago on titanium-gold, a 1-to-1 ratio compound that was a magnetic material made from nonmagnetic elements. One of the things that we do when we make a new compound is try to grind it into powder for X-ray purposes. This helps with identifying the composition, the purity, the crystal structure and other structural properties. “When we tried to grind up titanium-gold, we couldn’t,” she recalled. “I even bought a diamond (coated) mortar and pestle, and we still couldn’t grind it up.” Morosan and Svanidze decided to do follow-up tests to determine exactly
atoms tend to arrange in another cubic structure — the alpha form of titanium-3-gold. The alpha structure is about as hard as regular titanium. It appears that labs that had previously measured the hardness of One of the extra compounds was titanium-3-gold had measured samples a mixture of three parts titanium and that largely consisted of the alpha one part gold that had been prepared arrangement of atoms. at high temperature. The team measured the hardness What the team didn’t know at the of the beta form of the crystal in time was that making titanium-3-gold conjunction with colleagues at Texas at relatively high temperature produces A&M University’s Turbomachinery an almost pure crystalline form of the Laboratory and at the National beta version of the alloy — the crystal High Magnetic Field Laboratory at structure that’s four times harder than Florida State University, Morosan titanium. At lower temperatures, the and Svanidze also performed other how hard the compound was, and while they were at it, they also decided to measure the hardness of the other compositions of titanium and gold that they had used as comparisons in the original study.
comparisons with titanium. For biomedical implants, for example, two key measures are biocompatibility and wear resistance. Because titanium and gold by themselves are among the most biocompatible metals and are often used in medical implants, the team believed titanium-3-gold would be comparable. In fact, tests by colleagues at the University of Texas MD Anderson Cancer Center in Houston determined that the new alloy was even more biocompatible than pure titanium. The story proved much the same for wear resistance: Titanium-3-gold also outperformed pure titanium.
Mental Health
Continued from page 3 your child has problems waking up in then their nighttime sleep is probably reasons, such as a bedtime that is too or an inconsistent sleep schedule.” the morning or is sleepy during the day, inadequate. This can result for several late, non-restful sleep during the night see Mental Health page 21 medicaltimesnews.com
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Pearland Medical Center hosts Police Wives making ribbons for fallen officers Several of the wives of Pearland Police officers reached out to Pearland Medical Center for assistance with finding volunteers and putting together a community event that would benefit departments around the state and in Louisiana, where officer violence had recently occurred.
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The group made 1,700 blue ribbons and collected cards written by children to say, “Thank you.”
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“The staff at Pearland Medical Center was honored to offer a helping hand to the police wives to support the fallen officers,” said Leisha D’Angelo, Director of Community and Public Relations for Pearland Medical Center. “The response from the Pearland community was second to none. Parents brought their children to assist and it was nice to see the parents teaching their children to support our men and women in blue who leave their families every day to protect others. The children wrote heartfelt thank you letters in our ‘Thank a Cop’ campaign, while parents assembled the
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Center, Dr. Jaquin Coombs, MD, blue ribbons.” FACOG“Every day that we say goodbye to Obstetrics & Gynecology, Big Star our husbands, we know it could be the Ford, Missouri City Police Department last time. It meant so much to us that Support Squad, the Pearland Silverlake people we had never met before came Lions Club, Community Leaders, out to help us,” said Rachel Cohen, Channel 13 and many Pearland who is married to a Pearland Police children came to help out. Officer.
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Mental Health
Continued from page 19 Alfano says studying the link between sleep disruption and maladaptive emotional processing in childhood is essential, because that’s when sleep and emotion regulatory systems are developing. The increased need for sleep and greater brain plasticity during childhood suggests this to be a critical window of opportunity for early intervention. The combined societal costs of
anxiety and depressive disorders are estimated to be more than $120 billion annually, underscoring the need for early identification of risk factors and effective intervention methods.
study. Their article provides evidence that without adequate sleep, people are less likely to seek out positive or rewarding experiences if they require effort, such as social or leisure activities. A recent article appearing in Over time, they say, these behavioral the journal Sleep Medicine Reviews changes can elevate risk for depression authored by Palmer and Alfano and an overall poorer quality of life. “There are multiple emotional reviewed the scientific literature on sleep and emotion regulation, partly processes that seem to be disrupted by to inform the methods of their NIH poor sleep,” Alfano said. “For example,
our ability to self-monitor, pick up on others’ nonverbal cues and accurately identify others’ emotions diminishes when sleep is inadequate. Combine this with less impulse control, a hallmark feature of the teenage years, and sleep deprivation can create a ‘perfect storm’ for experiencing negative emotions and consequences.”
Legal Health
Continued from page 6 management plan, any security risks and vulnerabilities identified the risk analysis. 2. Perform an Encryption Status. ∙∙ Annually perform an encryption status that includes the implementation of a Mobile Device Management (MDM) solution that ensures all entity-owned and personally-owned mobile devices (tablets, smart phones, and other mobile devices) that access ePHI on the covered entity’s secure network are encrypted, except for any mobile devices for which the covered entity has granted exceptions to the encryption requirement. ∙∙ The covered entity should periodically test the effectiveness of its implemented solution to enforce encryption on covered entity-owned and personally-owned devices (laptops, desktops, and medical equipment) connecting to the covered entity’s secure wired network. ∙∙ Implement policies that prohibit the transfer of data containing ePHI from entity-owned and personally-owned devices to unencrypted removable storage devices (USB drives and portable hard drives). ∙∙ I m p l e m e n t technical solutions that enforce the policies prohibiting transfer of data containing ePHI to unencrypted removable
storage devices when attached to the covered-entity’s secure network. 3. Establish Policies and Procedures Related to Business Associate Relationships. ∙∙ Designate one or more individual(s) who are responsible for ensuring that business associate agreements are entered into with each business associate prior to disclosing PHI to the business associate. ∙∙ Assess current and future business relationships to determine whether each relationship is with a “business associate,” and requires a business associate agreement. ∙∙ Negotiate and enter into business associate agreements with business associates prior to disclosing PHI to the business associates. ∙∙ Create a standard template business associate agreement.
∙∙ Distribute Policies and Procedures that govern the security of individually identifiable health information to all current members of the workforce and to new members of the workforce within 15 days of their commencement of workforce service. ∙∙ Require, at the time of distribution of the Policies and Procedures, a signed written or electronic initial compliance certification from all workforce members stating that the workforce members have read, understand, and shall abide by the Policies and Procedures. Deny access to ePHI to any member of the workforce if that workforce member has not signed or provided the requisite written or electronic certification. ∙∙ The Policies and Procedures shall include, but shall not be limited to:
∙∙ Maintain documentation of a business associate agreement for at least 6 years beyond the date of when the business associate relationship is terminated.
∙∙ Uses and disclosures of PHI
∙∙ Limit disclosures of PHI to business associates to the minimum necessary amount of PHI that is reasonably necessary for the business associates to perform their duties.
∙∙ Mobile device controls
4. Establish Policies and Procedures that Comply with the Security Rule.
∙∙ Encryption of ePHI ∙∙ Password management ∙∙ Security incident response ∙∙ Workstation security ∙∙ I n f o r m a t i o n management
access
∙∙ Information system review ∙∙ Security management process
∙∙ Disaster recovery plan ∙∙ Emergency mode operation plan ∙∙ Testing and revising of contingency plans ∙∙ Applications and criticality analysis
data
∙∙ Automatic log off ∙∙ Audit controls ∙∙ Integrity controls. 5. Provide Training on Privacy and Security Awareness. ∙∙ Develop training materials relating to security awareness that are established to reduce the risks and vulnerabilities to ePHI. ∙∙ The training materials should also include privacy and security awareness related to: ∙∙ use of internet-based information storage services ∙∙ disclosures to third party entities that require a business associate agreement or other reasonable assurance in place to ensure that the business associate will safeguard PHI and/or ePHI ∙∙ effective oversight of workforce members’ uses and disclosures of PHI, including ePHI, to ensure the workforce members’ compliance with the Privacy and Security Rules and the covered-entity’s internal policies and procedures;
∙∙ Security reminders
∙∙ security incident reporting, and
∙∙ Log-in monitoring
∙∙ password management.
∙∙ Data backup plan
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see Legal Health page 22 August 2016
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Legal Health
HOUSTON
Continued from page 21 ∙∙ Provide privacy and security awareness training to each newly hired workforce member with access to PHI and/or ePHI within 15 days of beginning work and annually to all other workforce member with access to PHI and/or ePHI.
∙∙ Review the security awareness training materials annually, and, where appropriate, update the training to reflect changes in Federal law or guidance, any issues discovered during audits or reviews, and any other relevant developments.
actions recommended by the OCR, a covered entity or a business associate can better demonstrate that it has taken appropriate action to safeguard sensitive health information and reduce identified risks and vulnerabilities to a reasonable and appropriate level, thereby mitigating its exposure should By implementing these five a breach occur.
Legal Health
Continued from page 7 gained from tumor immunology “as sequencing and epitope prediction now permit the definition of T cell responses against mutant antigens within individual patients, and should now allow the natural immunological history of a patients tumor to be followed before and after therapy”. To Dr. Alexandra Snyder, physician scientist at Gynecologic Medical Oncology and Immunotherapy services at Memorial Sloan Kettering Cancer Center the two biggest problems facing checkpoint immunotherapy are scientific and societal. The first, as a scientific problem “Although
immunotherapy is certainly an important component of cancer therapy, it may not be the universal panacea for all cancers, especially when considered as a single intervention”; The second, societal “The high cost of antibody therapies will weigh heavily on health-care systems that are already overstrained, in part by the cost of cancer care”. “Before we discuss issues of resistance to immunotherapy, it should be duly noted that immunotherapy is a true paradigm shift in the treatment of patients with metastatic cancer. In terms of lives saved and person-years
restored, immunotherapy promises to be more significant than any other form of treatment for patients whose tumors have already metastasized. For patients with metastatic solid tumors, surgery, radiotherapy, chemotherapy and even targeted pathway inhibition with small molecules are generally not curative”, said Dr. Nicholas P. Restifo. Newer technologies focusing genomic, epigenetic events and transcriptomic in cancer cells will deeply facilitate researchers to propose and predict effective combinations in cancer immunotherapy.
MD Anderson
Continued from page 9 suit created with patients at MD Anderson, many of whom were on isolation during their treatment, is meant to demonstrate the courage it takes to be isolated from family and friends during long periods of time. Astronauts face similar isolation “Even though my cancer is back during space exploration missions. after I already survived it twice, working Stott took a watercolor paint kit on her on this project makes the days go faster space missions to remain connected and reminds me about the importance to the world left behind and to help of hope,’ said Jacob, a 17-year-old document her experiences. Ewing’s sarcoma survivor. “I’m excited Creation of the third space suit, to tell people that my art may go to UNITY, will be an international space, and, one day, I hope to work collaboration with children’s hospitals with the space exploration vehicles at around the world. The UNITY space NASA.” suit will represent the global issues progress in childhood cancer research, which is consistently underfunded, and hope that childhood diseases like cancer can one day be eliminated. One patient inspired by the Space Suit Art Project and who provided artwork for the first two suits shared his hope.
a goal to unite others, help spread awareness about childhood cancers and offer hope and courage to cancer patients around the globe.
“The kids and families we’ve met during this creative journey have shown us all the importance of hope, the power of courage and the strength of unity,” said Stott. “All of the partners involved with this project and I hope people will see these works of art and they will be inspired to learn more about the story behind it, which is the need for increased awareness of childhood cancer. There’s so much work to be done for pediatric cancer research — we’re just trying to do our COURAGE, the second space surrounding childhood cancers, with little part.”
YMCA
Continued from page 18 haven’t walked in a while.” Exercise can improve a person’s emotional and mental state as well. August 2016
“When you stay at home, you in your mind,” Sailor said. “If you’re get caught in a cycle of depression. busy and engaged with other people, Your pain can be first and foremost the pain actually takes a backseat.” medicaltimesnews.com
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life is why. To improve the lives of all Americans, we provide public health education in a variety of ways by building healthier lives, free of cardiovascular diseases and stroke. It’s why we’ve made better heart and brain health our mission. But we are just beginning. Until there’s a world free of heart disease and stroke, we’ll be here, working to make a healthier, longer life possible for everyone. www.Heart.org/Houston Thank you to Texas Medical Center and its leadership for supporting the American Heart Association’s Go Red for Women and Heart Walk campaigns.
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